Robotic totally endoscopic coronary artery bypass: A word of caution implicated by a five-year follow-up

Kappert, Utz; Tugtekin, Sems Malte; Cichoń, Romuald; Braun, Martin; Matschke, Klaus

doi:10.1016/j.jtcvs.2007.11.018

Cited by 39 publications

(28 citation statements)

References 11 publications

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“…In a follow-up study of the Dresden experience, freedom from major adverse cardiac and cerebral events for the first 41 patients at 5 years was 75.6%. 43 We found a similar rate of major adverse events in our first 25 single-vessel AHTECAB patients, 26 but in this Innsbruck Medical University experience, we also noted a dramatic improvement of freedom from major adverse cardiac and cerebral events for the second, third, and fourth cohorts of 25 patients. Intramyocardial, heavily calcified, and very small target vessels in beating heart approaches Ascending aortic diameter Ͼ35 mm and significant aortoiliac atherosclerosis in on-pump arrested heart approaches CABG procedures were performed at the 2 institutions.…”

Section: Intermediate and Long-term Resultssupporting

confidence: 60%

Robotically Assisted Totally Endoscopic Coronary Bypass Surgery

Bonatti

Schachner²,

Bonaros³

et al. 2011

Circulation

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Section: Intermediate and Long-term Resultssupporting

confidence: 60%

Robotically Assisted Totally Endoscopic Coronary Bypass Surgery

Bonatti

Schachner²,

Bonaros³

et al. 2011

Circulation

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“…One study provided separate data for both the TECAB offpump and robotic MIDCAB groups, and was included for analysis in both groups (10). Eighteen additional studies reported on a mixture of different surgical techniques (18,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53). A summary of the study selection process is presented in the PRISMA chart in Figure 1, and a summary of study characteristics is presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-one studies were excluded from the final analysis due to a mixed dataset for different surgical techniques (42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) or use of cardiopulmonary bypass (36)(37)(38)(39)(40)(41), or use of an outdated robotic system other than the da Vinci system (18,34,35). Of the patients who were included for statistical analysis in the selected studies on off-pump TECAB, on-pump TECAB and robotic MIDCAB, the mean age ranged from 58 to 67, and 51-88% of patients were male.…”

Section: Resultsmentioning

confidence: 99%

A systematic review on robotic coronary artery bypass graft surgery

Cao

Indraratna

Doyle

et al. 2016

Ann. Cardiothorac. Surg.

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Background: Robotic-assisted coronary artery bypass graft surgery (CABG) has been performed over the past decade. Despite encouraging results from selected centres, there is a paucity of robust clinical data to establish its clinical safety and efficacy. The present systematic review aimed to identify all relevant clinical data on robotic CABG. The primary endpoint was perioperative mortality, and secondary endpoints included perioperative morbidities, anastomotic complications, and long-term survival.Methods: Electronic searches were performed using three online databases from their dates of inception to 2016. Relevant studies fulfilling the predefined search criteria were categorized according to surgical techniques as (I) totally endoscopic coronary artery bypass without cardiopulmonary bypass (TECAB offpump); (II) TECAB on-pump; and robotic-assisted mammary artery harvesting followed by minimally invasive direct coronary artery bypass (robotic MIDCAB).Results: The present systematic review identified 44 studies that fulfilled the study selection criteria, including nine studies in the TECAB off-pump group and 16 studies in the robotic MIDCAB group.Statistical analysis reported a pooled mortality of 1.7% for the TECAB off-pump group and 1.0% for the robotic MIDCAB group. Intraoperative details such as the number and location of grafts performed, operative times and conversion rates, as well as postoperative secondary endpoints such as morbidities, anastomotic complications and long-term outcomes were also summarized for both techniques.Conclusions: A number of technical, logistic and cost-related issues continue to hinder the popularization of the robotic CABG procedure. Current clinical evidence is limited by a lack of randomized controlled trials, heterogeneous definition of techniques and complications, as well as a lack of robust clinical followup with routine angiography. Nonetheless, the present systematic review reported acceptable perioperative mortality rates for selected patients at specialized centres. These results should be considered as a useful benchmark for future studies, until further data is reported in the form of randomized trials.

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“…One study even reports 100% survival at 41 months (9). In another paper showing 93% survival at 5 years, all deaths on followup were non-cardiac in nature (4). Figure 1 depicts the collective survival curve derived from the literature data.…”

Section: Methodsmentioning

confidence: 99%

Long-term results after robotically assisted coronary bypass surgery

Bonatti

Ramahi²,

Hasan³

et al. 2016

Ann. Cardiothorac. Surg.

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Background: Robotically-assisted coronary bypass grafting (CABG) was introduced in 1998 and dedicated centers have continuously applied and developed this minimally invasive method of coronary bypass surgery.While short-term results are relatively well published, data on long-term outcome are limited. In this literature review, we assessed the outcomes after robotic CABG following the first postoperative year. Methods:We searched PubMed for articles containing the terms "robotic" or "robotically assisted" and "coronary bypass". A total of 11 papers contained long-term results. We specifically investigated survival, graft patency, freedom from angina and re-intervention, as well as freedom from major adverse cardiac and cerebrovascular events (MACCE).Results: Five-year survival after robotic CABG was consistently consistently greater than 90% and graft patency between 3 and 5 years was reported to be above 90%. Fifteen percent to 26% of patients reexperienced angina at 3 to 5 years postoperatively. Long-term freedom from re-intervention reached the range and the 5-year freedom from MACCE rate was approximately 75%.Conclusions: According to data in the literature, long-term results after CABG carried out with the assistance of a surgical robot appear to be in line with results achieved after conventional CABG.

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Robotic totally endoscopic coronary artery bypass: A word of caution implicated by a five-year follow-up

Cited by 39 publications

References 11 publications

Robotically Assisted Totally Endoscopic Coronary Bypass Surgery

Robotically Assisted Totally Endoscopic Coronary Bypass Surgery

A systematic review on robotic coronary artery bypass graft surgery

Long-term results after robotically assisted coronary bypass surgery

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